Individual provider Active NPI

Paulina Trujillo Perez

  • Marriage & Family Therapist
  • Montclair, CA
National Provider Identifier
1689982498
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
9916 Central Ave.
Montclair, CA 91763
Phone
(909) 450-2502
Fax
(909) 450-0237
NPI assigned
Sep 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

9916 Central Ave.
Montclair, CA 91763

Mailing address

9916 Central Ave.
Montclair, CA 91763
Phone (909) 450-2502

Other practice location 1

1333 Iris Ave
Boulder, CO 80304-2226
Phone (303) 413-6212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1689982498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9916 CENTRAL AVE.",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "91763",
            "telephone_number": "909-450-2502",
            "fax_number": "909-450-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9916 CENTRAL AVE.",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "91763",
            "telephone_number": "909-450-2502",
            "fax_number": "909-450-0237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 Iris Ave",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803042226",
            "country_code": "US",
            "telephone_number": "303-413-6212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUJILLO PEREZ",
        "first_name": "PAULINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

Verify at the official NPI Registry.